A Pilot Project Using Language-Interpreting Modalities in High-Fidelity Obstetric Simulations

Abstract

The purpose of this innovative program was to provide undergraduate nursing students a controlled opportunity to care for a patient with limited English proficiency (LEP) and initiate the procurement of interpreting services. Nurses are expected to provide culturally appropriate care to clients of all ethnicities, including those who have LEP. However, clinical agencies are unable to guarantee opportunities for students to work with patients with LEP during clinicals. Though some students may be able to work alongside a nurse who is caring for a patient with LEP, it is unlikely that all students across a nursing program would have the same opportunity. A high-fidelity simulation pilot project was devised within an obstetrics course in an undergraduate nursing program to provide students this opportunity. A convenience sampling of senior nursing students cared for simulated patients in various obstetric scenarios, such as shoulder dystocia and postpartum hemorrhage. All patients spoke limited English and were of Latino ethnicity. Students were expected to provide quality obstetric care as well as initiate, procure, and use interpretation services through the duration of the simulation. A standardized Latino patient voice was played by a nursing faculty member, and interpreter services were of various modalities, ranging from a certified language interpreter from the university’s language department to electronic- and operator-based interpreter systems. Students debriefed and provided feedback after the scenarios. Faculty assessed student clinical performance as well as the timely initiation and effective use of interpreter services. Although some students were surprised that the patient did not speak English, all students quickly recognized that the language spoken was Spanish. They procured an interpreter and used the service throughout the simulation. The students stated that the simulation offered an opportunity to implement what they had learned throughout the curriculum. In addition, students rated the exercise as effective in helping them feel equipped to provide this service in the clinical setting. Students should have opportunities during their training to work with patients with LEP who need interpreters. Nurses’ ability to provide culturally appropriate care may be enhanced and assessed thorugh high-fidelity simulations.